Sickness certification at oncology clinics: perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences R. BRÄNSTRÖM, PHD, Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, and Department of Public Health Sciences, Karolinska Institutet, Stockholm, B. ARRELÖV, PHD, Stockholm County Council, Stockholm, C. GUSTAVSSON, PHD, Department of Clinical Neuroscience, Divi- sion of Insurance Medicine, Karolinska Institutet, Stockholm, L. KJELDGÅRD, MSC, Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, T. LJUNGQUIST, PHD, Depart- ment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, G.H. NILSSON, PHD, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institutet, Stockholm, & K. ALEXANDERSON, PHD, Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden BRÄNSTRÖM R., ARRELÖV B., GUSTAVSSON C., KJELDGÅRD L., LJUNGQUIST T., NILSSON G.H. & ALEXANDERSON K. (2013) European Journal of Cancer Care Sickness certification at oncology clinics: perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences Physicians’ work with sickness certifications is an understudied field. The aims of this study were to gain knowledge of experiences concerning the sickness certification process among physicians working at oncology clinics. In 2008, all physicians working in Sweden (n = 36 898) were sent a questionnaire concerning sick- listing practices. All respondents working at an oncology clinic (n = 428) were included in the current study. Most of the physicians had sickness certification consultations at least weekly (91.3%). More than one fifth (22.3%) reported that they worked at a clinic with a workplace policy regarding the handling of sickness certification and 61.1% reported receiving at least some support in such cases from their immediate manager. Issuing unnecessary long sickness certificates were related to experiencing delicate interactions with patients and to lack of time. To a moderate degree, further competence was requested regarding: different types of compensation in the social insurance system, responsibilities of the Social Insurance Agency and employers, and sickness insurance rules. The large majority of physicians working in oncology reported regularly having consultations involving sickness certification. Overall, they reported few problems, low level of need for more competence regarding sickness certification, and low frequency of issuing sickness absences for longer periods than necessary. Keywords: sick leave, sickness certification, insurance medicine, oncology, cancer, physician. INTRODUCTION Do oncologists find sickness certification consultations problematic? Do they feel a need for more competence regarding such tasks? For the first time, a large-scale nationwide survey regarding work with sickness certifica- tion has been conducted among physicians at oncology clinics in Sweden. Correspondence address: Richard Bränström, Department of Clinical Neu- roscience, Division of Insurance Medicine, Karolinska Institutet, Stock- holm 171 76, Sweden (e-mail: richard.branstrom@ki.se). Accepted 22 June 2013 DOI: 10.1111/ecc.12104 European Journal of Cancer Care, 2013 Original article © 2013 John Wiley & Sons Ltd